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September 2010

Perfluorooctanoic Acid, Perfluorooctanesulfonate, and Serum Lipids in Children and Adolescents: Results From the C8 Health Project

Author Affiliations

Author Affiliations: Department of Community Medicine (Ms Frisbee and Drs Shankar, Knox, and Ducatman) and Center for Cardiovascular and Respiratory Sciences (Ms Frisbee and Dr Shankar), West Virginia University School of Medicine, Morgantown; Department of Environmental and Occupational Health, Emory University Rollins School of Public Health, Atlanta, Georgia (Dr Steenland); Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York (Dr Savitz); and Public Health and Environmental Research Unit, London School of Hygiene and Tropical Medicine, London, England (Dr Fletcher).

Arch Pediatr Adolesc Med. 2010;164(9):860-869. doi:10.1001/archpediatrics.2010.163

Background  Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) are man-made compounds with widespread presence in human sera. In previous occupational and adult studies, PFOA and PFOS were positively associated with serum lipid levels.

Objective  To interrogate associations between PFOA and PFOS and serum lipids in children and adolescents.

Design  Cross-sectional community-based study.

Setting  Mid–Ohio River Valley.

Participants  A total of 12 476 children and adolescents included in the C8 Health Project, which resulted from the pretrial settlement of a class action lawsuit pursuant to PFOA contamination of the drinking water supply.

Main Outcome Measures  Serum lipids (total, high-density lipoprotein [HDL-C], and low-density lipoprotein [LDL-C] cholesterol and fasting triglycerides).

Results  Mean (SD) serum PFOA and PFOS concentrations were 69.2 (111.9) ng/mL and 22.7 (12.6) ng/mL, respectively. In linear regression after adjustment for covariables, PFOA was significantly associated with increased total cholesterol and LDL-C, and PFOS was significantly associated with increased total cholesterol, HDL-C, and LDL-C. Using general linear model analysis of covariance, between the first and fifth quintiles of PFOA there was a 4.6-mg/dL and a 3.8-mg/dL increase in the adjusted mean levels of total cholesterol and LDL-C levels, respectively, and an 8.5-mg/dL and a 5.8-mg/dL increase in the adjusted mean levels of total cholesterol and LDL-C, respectively, between the first and fifth quintiles of PFOS. Increases were 10 mg/dL for some age- and sex-group strata. Observed effects were nonlinear, with larger increases in total cholesterol and LDL-C levels occurring at the lowest range, particularly of PFOA.

Conclusion  Although the epidemiologic and cross-sectional natures of this study limit causal inferences, the consistently observed associations between increasing PFOA and PFOS and elevated total cholesterol and LDL-C levels warrant further study.